April 2008

Failing with women: How clinical trials fail our largest subgroup

September 04, 2008

Lipids

The current guidelines for the management of heart failure in women are based upon data collected from studies predominantly enrolling men. However, because important differences exist in the sex-based pathogenesis of and prognosis for heart failure, the current risk-benefit analyses that guide the evidence-based management of heart failure in women demands prospective assessment.

Iatrogenic dilated cardiomyopathy and spectrum of current treatment modalities

September 04, 2008

Lipids

Our increasing ability to intervene in high-risk patients—with lower risks and greater chances for successful outcomes—is felt across the broad spectrum of cardiovascular disease. This is particularly evident in patients with dilated cardiomyopathy (DCM).

Comprehensive lifestyle modification and blood pressure control

September 04, 2008

Lipids

Lifestyle recommendations for the prevention and treatment of hypertension include weight loss, reduced sodium intake, increased physical activity, limited alcohol intake, and the Dietary Approaches to Stop Hypertension (DASH) diet. The 18-month results of the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER) randomized clinical trial showed that individuals with prehypertension and stage 1 hypertension can make and sustain many of these lifestyle changes over the long term, thereby reducing their risk of cardiovascular disease.

Are statins cardioprotective in patients undergoing major vascular surgery?

September 04, 2008

Lipids

We evaluated the cardioprotective effects of intensive statin therapy before major vascular surgery in a prospective study of 359 subjects. After multivariate analysis, lower low-density lipoprotein (LDL) cholesterol was associated with decreased myocardial ischemia, troponin T release, and 30-day and late cardiac events. Furthermore, higher doses of statins were associated with better cardiac outcome, even after adjusting for LDL cholesterol.

Combining warfarin and antiplatelet therapy after coronary stenting

September 04, 2008

Lipids

We conducted an observational study to compare singleantiplatelet therapy with dualantiplatelet therapy among patients requiring long-term warfarin therapy after coronary stenting. Results showed that there was no difference in mortality or myocardial infarction between the 2 treatment regimens at 6 months, with no excess in-hospital bleeding; however, larger trials are needed to determine firm recommendations.

Anticoagulation regimens after stent insertion

September 04, 2008

Lipids

In this period of heightened concern over the increased risk of late and very late stent thrombosis with the use of drug-eluting stents, it is worthwhile to examine the anticoagulation regimens given after insertion of a stent.